Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 01064 | Date 05/10/2018 |
| Token No | SM/18-19/1389 05/10/2018 | Serial | 030 |
| Patient Name | Mrs. RITA SIL | Contact No | |
| Address | BATTALA | Age | 45 Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | 128/82 mmHg | Weight | 59 KG |
| Pulse Rate | 80 / min | Height | cm |
| Diagnosis | |||